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201 Lecture 32010 Dissociative Disordersstudent

Dissociative disorders disrupt normal consciousness and identity. They may present as severe disturbances in personality. There are several types of amnesia including localized, selective, continuous, generalized, and systematized. Dissociative identity disorder involves two or more personalities. Depersonalization disorder causes feelings of detachment. Treatment depends on the specific disorder but may include removing stressors, psychotherapy, and in rare cases intravenous medication. Nursing care involves assessment, diagnosis, education, and supporting therapeutic interventions.

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41 views

201 Lecture 32010 Dissociative Disordersstudent

Dissociative disorders disrupt normal consciousness and identity. They may present as severe disturbances in personality. There are several types of amnesia including localized, selective, continuous, generalized, and systematized. Dissociative identity disorder involves two or more personalities. Depersonalization disorder causes feelings of detachment. Treatment depends on the specific disorder but may include removing stressors, psychotherapy, and in rare cases intravenous medication. Nursing care involves assessment, diagnosis, education, and supporting therapeutic interventions.

Uploaded by

Knmp Rulez
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Dissociative Disorders

Chapter 9
Introduction
• Dissociative disorders are defined by a disruption
in the usually integrated functions of
consciousness, memory, identity, or perception.
• Dissociative disorders are thought to be quite
rare, but when they do occur they may present a
very dramatic clinical picture of severe
disturbance in normal personality
functioning.
• There is an increase in reported cases of amnesia.
Amnesia: Assessment
• Localized amnesia
– Inability to recall all incidents associated with the traumatic event for
a specific time period following the event.
• Selective amnesia
– Inability to recall only certain incidents associated with a traumatic
event for a specific period after the event.
• Continuous amnesia
– Inability to recall events occurring after a specific time up to and
including the present.
• Generalized amnesia
– Rare phenomenon of not being able to recall anything that has
happened during the person’s entire lifetime, including his or her
personal identity
• Systematized amnesia
– Person cannot remember events that relate to a specific category of
information, such as one’s family or on particular person or event.
Localized amnesia

• Assessment
• Nursing Diagnosis
• Nursing Intervention
• Patient and family Education
Selective amnesia

• Assessment
• Nursing Diagnosis
• Nursing Intervention
• Patient and family Education
Continuous amnesia
• Assessment
• Nursing Diagnosis
• Nursing Intervention
• Patient and family Education
Generalized amnesia

• Assessment
• Nursing Diagnosis
• Nursing Intervention
• Patient and family Education
Systematized amnesia

• Assessment
• Nursing Diagnosis
• Nursing Intervention
• Patient and family Education
Dissociative Fugue: Assessment
• Characteristic feature of dissociative
fugue is a sudden, unexpected travel
away from home or customary workplace
• A person in a fugue state unable to recall
personal identity, and assumption of a new
identity is common
Nursing Process

• Nursing Diagnosis
• Planning/Implementation
• Outcomes
• Evaluation
Dissociative Identity Disorder:
Assessment
• Characterized by the existence of two or more
personalities within a single individual
• Transition from one personality to another is
usually sudden, often dramatic, and
usually precipitated by stress
Nursing Process

• Nursing Diagnosis
• Planning/Implementation
• Outcomes
• Evaluation
Predisposing Factors
• Biological Theories
– Genetics
• Possible hereditary factor
– Organic
• Certain neurological conditions may predispose
individuals to DID
• Psychological Influences:History of Traumatic
Experience
• Sexual abuse, Psychological abuse andPhysical
abuse
Depersonalization Disorder
• Assessment: Characterized by a temporary
change in the quality of self-awareness that
often takes the form of:
– Feelings of unreality
– Changes in body image
– Feelings of detachment from the environment
– Sense of observing oneself from outside the body
• Symptoms of depersonalization disorder are
often accompanied by:
– Anxiety
– Fear of going insane
– Depression
– Obsessive thoughts
– Somatic complaints
– Disturbance in the
subjective sense of time
• Physiological theory
– Neurophysiological basis
• Psychodynamic theory
– Emphasizes the psychological conflict and disturbances
of ego structure in the predisposition to
depersonalization disorder
Nursing Process

• Nursing Diagnosis
• Planning/Implementation
• Outcomes
• Evaluation
• Client/Family Education
Treatment Modalities
• Dissociative amnesia
– Remove from stress
– Intravenous amobarbital
– Supportive psychotherapy

• Dissociative fugue
– Cognitive therapy
– Group therapy
– Family therapy
Treatment Modalities
• Dissociative identity disorder
– Intense long-term psychotherapy
• Depersonalization disorder
– Various regimens have been tried, although none
has proved widely successful.

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